JP6926631B2 - Fluorescence observation unit - Google Patents

Description

The present invention relates to a fluorescence observation unit used for medical diagnosis by irradiating a suspected positive affected area with excitation light and observing fluorescence. The present invention also relates to an observation instrument and a light-shielding member used in such a fluorescence observation unit.

In recent years, the number of cancer patients has been increasing. For example, as a method for diagnosing cervical cancer, first, the cervix is rubbed with a cotton swab, stained, and observed under a microscope with visible light. Then, for patients suspected of having cancer, a microscope called a culposcope is used to observe the cervix by illuminating the cervix from outside the body with the diameter of the vagina enlarged using a member called a speculum. The doctor observes the affected area. Then, for patients with a high suspicion of cancer, a doctor excises a part of the excised tissue while looking into the cervix with a culposcope, and makes a pathological diagnosis for the excised tissue. Visible light such as a halogen lamp, a xenon lamp, or a white LED is used as a light source for illumination used in a culpascope.

As another prior art, for example, Patent Document 1 below describes an instrument for observing the inside of the vagina using an optical system such as a rigid mirror and a tip cap. Further, Patent Document 2 below describes a device for realizing observation of the cervix without unnecessarily dilating the vagina. Specifically, it is said that the cervix can be photographed with a minimum of vaginal dilation by inserting a cylindrical device equipped with a camera and a light source at the tip into the vagina.

Japanese Unexamined Patent Publication No. 2008-515573 Japanese Unexamined Patent Publication No. 2016-1544848

The present inventors have considered that it can be applied to the diagnosis of the suspected positive affected area by irradiating the suspected positive affected area with excitation light and observing the received fluorescence through diligent research. However, at that time, we found that there were the following issues.

Fluorescence has an extremely weak intensity as compared with the excitation light. Therefore, in order to observe the fluorescence of the cervix using the existing speculum and culposcope, it is necessary to capture such a weak fluorescence signal with a high S / N ratio. For this purpose, it is important to prevent ambient light. As measures for that, (1) cover the patient's lower body and the culpascope, (2) turn off the interior lights, (3) block the natural light entering through the window with a curtain, etc., (4) turn off the luminescent device such as the display. It is necessary to go through the procedures such as (5) turning on the interior light again after the observation is completed. It is extremely complicated to carry out such a procedure for each observation.

On the other hand, by utilizing an endoscope-type culpascope as described in, for example, Patent Document 1 and Patent Document 2, it seems that measures against ambient light become unnecessary. However, it is necessary to prevent fogging of the optical system due to humidity in the hollow organ, and specifically, it is essential to add a heater that warms the endoscope body to about body temperature. As a result, the size of the device is increased and the cost is increased.

In addition, there are several types of cervical observation devices, such as an endoscope type that is inserted directly into a hollow organ, more specifically, a flexible mirror type that has a camera and light source at the tip, and a rigid mirror type that has a camera and light source at the base. There are some, and it seems that the above complicated operations will not be necessary by using these. However, in the case of the flexible mirror type, an extremely small camera is required to keep the diameter small, and the area of the image sensor becomes small, so that the sensitivity is significantly lowered. Further, even in the rigid mirror type, since it is inevitable to use an optical system with a large loss using a fiber or a rod lens, it is still difficult to receive fluorescence of a light amount sufficient for diagnosis.

In view of the above problems, it is an object of the present invention to provide a compact and inexpensive fluorescence observation unit capable of accurate diagnosis by observing fluorescence emitted from a suspected positive affected area. Another object of the present invention is to provide a fluorescence observation device, an observation instrument, and a light-shielding member used for such a fluorescence observation unit.

The fluorescence observation unit according to the present invention is
A light source unit that irradiates the suspected positive affected area in the inner observation site of the hollow organ whose outer surface opening is expanded by inserting the expansion member, and a light source unit.
A light receiving part that receives fluorescence emitted from the suspected positive affected part by irradiating the suspected positive affected part with the excitation light, and a light receiving part that receives the fluorescence emitted from the suspected positive affected part.
A tubular light-shielding member that shields an optical path from a surface of the expansion member on the light-receiving part side to the light-receiving part is provided.
The excitation light is guided to the suspected positive affected area through the inside of the light-shielding member and the inside of the expansion member.
The fluorescence is guided to the light receiving portion through the inside of the expansion member and the inside of the light shielding member.

According to the above configuration, since diagnosis can be performed without using an endoscope-type light source device, it is possible to secure a sufficient amount of fluorescence with a small device. Further, the expansion member used for expanding the observation site and the light receiving portion are connected by a tubular light-shielding member to form a closed space. This enclosed space effectively constitutes a darkroom. Then, the fluorescence emitted from the suspected positive affected area passes through this closed space. Therefore, the possibility that the ambient light is mixed with the fluorescence and received by the light receiving unit is remarkably reduced, and the diagnostic accuracy is improved.

In addition to the above configuration, it has a main body case for accommodating the light receiving portion.
The light-shielding member may be connected to the surface of the main body case on the side where the fluorescence is incident.

In this case, the main body case may accommodate the light source portion and the light receiving portion.

In the above configuration, the expansion member may be a speculum.

The light-shielding member may be physically deformable. More specifically, the light-shielding member may be at least partially formed in a bellows shape, or may be made of an elastic member.

According to such a configuration, it is possible to reduce the burden on the patient by deforming the light-shielding member when adjusting the optical axis between the observation portion and the light source portion.

The light-shielding member may be made of a low autofluorescent substance.

Here, the material having low autofluorescence means a material in which the intensity of autofluorescence of the light-shielding member is negligible (for example, 10% or less) as compared with the intensity of fluorescence derived from the suspected positive affected area. As an example, the intensity of autofluorescence of the holder is preferably 10% or less with respect to the intensity of fluorescence emitted from the sample to be measured. However, the range of autofluorescence intensity, which has little effect on the intensity of fluorescence derived from the suspected positive affected area, can be appropriately changed depending on the accuracy of measurement.

The excitation light may have a wavelength of 410 nm or less.

The fluorescence observation unit may be configured to include the expansion member.

The observation instrument according to the present invention is
It is an observation instrument for fluorescent observation of the suspected positive affected area in the observation site inside the hollow organ.
With a tubular light-shielding member
It is characterized by including an expansion member for expanding the outer surface opening of the hollow organ, which is connected to the surface of the light-shielding member.

The light-shielding member according to the present invention is
A light-shielding member used for fluorescence observation of a suspected positive affected area in an observation site inside a hollow organ.
A first end portion for connecting to an expansion member for expanding the suspected positive affected area and a first portion for connecting to a main body case containing a light receiving portion for receiving fluorescence emitted from the suspected positive affected area. It is characterized by having a tubular shape including two ends.

According to the present invention, it is possible to make an accurate diagnosis by observing the fluorescence emitted from the suspected positive affected area with a small and inexpensive system.

It is a perspective view which shows typically the structure of one Embodiment of the fluorescence observation unit of this invention. It is a top view which shows typically the structure of one Embodiment of the fluorescence observation unit shown in FIG. This is an example schematically showing the shape of the light-shielding member. This is an example schematically showing the shape of the light-shielding member. This is an example schematically showing the shape of the light-shielding member. It is a drawing which shows concrete example of the connection method between a light-shielding member and a main body case. It is a drawing which shows concrete example of the connection method between a light-shielding member and a main body case. It is a drawing which shows concrete example of the connection method between a light-shielding member and a main body case. It is a drawing which shows concrete example of the connection method between a light-shielding member and a main body case.

Embodiments of the fluorescence observation unit, the fluorescence observation device, the observation instrument, and the light-shielding member of the present invention will be described with reference to the drawings. In each drawing, the dimensional ratio in the drawing does not always match the actual dimensional ratio.

FIG. 1 is a perspective view schematically showing the configuration of one embodiment of the fluorescence observation unit. Further, FIG. 2 is a plan view schematically showing the configuration of an embodiment of the fluorescence observation unit shown in FIG. Note that FIG. 2 also shows a ray diagram and an observation site for convenience of explanation.

The fluorescence observation unit 1 includes an expansion member 10, a light-shielding member 20, and a main body case 30. In the present embodiment, the main body case 30 includes a housing 31, a light source unit 32, a dichroic mirror 33, an optical member 34, and a light receiving unit 35. The light-shielding member 20 is made of a material capable of blocking light from the outside and has a tubular shape. The light-shielding member 20 can be made of various materials such as a resin, an opaque cloth, an elastic body such as a rubber film, and a metal.

The expansion member 10 is a member for expanding the outer surface opening 41 of the hollow organ 40. Examples of the hollow organ 40 include the vagina, rectum, nasal cavity, and ear cavity. In the present embodiment, the expansion member 10 has an upper blade member 11, a lower blade member 12, and a handle portion 13. By adjusting the handle portion 13, the opening angle between the upper blade member 11 and the lower blade member 12 is adjusted. The expansion member 10 may have a fulcrum at the base where the handle portion 13 is provided, and the size of the root portion may be kept substantially constant regardless of the opening angle. When the hollow organ 40 is the vagina, the dilation member 10 can utilize a Cusco speculum as an example.

The light-shielding member 20 includes ends 21 and 22. The end portion 21 (corresponding to the "first end portion") is connected to the expansion member 10, and the end portion 22 (corresponding to the "second end portion") is connected to the surface of the main body case 30. As a result, the light-shielding member 20 forms a tubular closed space.

The light source unit 32 is a light source that emits ultraviolet light having a wavelength of 240 nm or more and 410 nm or less, and is equipped with, for example, a mercury lamp or an LED element. The dichroic mirror 33 is configured to reflect light in the wavelength range emitted from the light source unit 32 and to transmit light having a wavelength of 420 nm or more and 900 nm or less, which is a longer wavelength than that.

The excitation light 5 in the ultraviolet region emitted from the light source unit 32 is reflected by the dichroic mirror 33 and then guided into the light-shielding member 20. Then, after propagating in the light-shielding member 20, it is guided into the hollow organ 40 through the opening portion of the expansion member 10. Then, the excitation light 5 is irradiated to the suspected positive affected portion 42 in the hollow organ 40.

When the suspected positive affected area 42 is irradiated with the excitation light 5, it generates fluorescence 6 derived from an inherent substance. This fluorescence 6 shows a spectrum depending on the substance contained in the suspected positive affected area 42, and the spectrum differs depending on whether or not a specific tumor is contained. An example of the wavelength of fluorescence 6 is 420 nm or more and 450 nm or less. That is, as described above, the dichroic mirror 33 is configured to transmit the fluorescence 6.

Fluorescence 6 proceeds in the opposite direction to the excitation light 5. That is, the fluorescence 6 is guided into the light-shielding member 20 through the opening portion of the expansion member 10. After that, the fluorescence 6 is guided into the main body case 30, passes through the dichroic mirror 33, and is guided to the light receiving portion 35 via the optical member 34. The light receiving unit 35 performs image analysis based on the received fluorescence 6. The optical member 34 is composed of one or more optical lenses as an example, but it is not always necessary.

According to the above configuration, since the space of the light-shielding member 20 forming the region through which the fluorescence 6 passes is substantially a dark room, it is possible to suppress the invasion of light from the outside into the region. As a result, even if the fluorescence 6 has a low intensity, it can be received by the light receiving unit 35 in a state of having a high S / N ratio, and the diagnostic accuracy can be improved.

The method of using the fluorescence observation unit 1 is as follows.

A "fluorescence observation device" is manufactured by connecting the main body case 30 and the end portion 22 of the light-shielding member 20. The expansion member 10 is inserted into the hollow organ 40 through the outer surface opening 41 of the patient and opened by a predetermined angle. After that, the expansion member 10 and the end portion 21 of the light-shielding member 20 are connected. Then, the light source unit 32 is made to emit light, and the light receiving unit 35 is observed.

As another method, an "observation instrument" is manufactured by connecting the end portion 21 of the light-shielding member 20 and the expansion member 10. The expansion member 10 included in the observation instrument is inserted into the hollow organ 40 through the outer surface opening 41 of the patient and opened by a predetermined angle. After that, the main body case 30 and the end portion 22 of the light-shielding member 20 are connected. Then, the light source unit 32 is made to emit light, and the light receiving unit 35 is observed.

The light-shielding member 20 is preferably configured so that its shape can be easily changed. Since there are individual differences in the body shape and posture of the patient, it is expected that the expansion member 10, the light-shielding member 20, and the main body case 30 will not be arranged immediately before the fluorescence observation unit 1 is set for the patient. .. Since the light-shielding member 20 is deformably configured, the optical axis connecting the light source portion 32, the suspect-positive affected portion 42, and the light-receiving portion 35 can be easily adjusted by simply deforming the shape of the light-shielding member 20. ..

3A to 3C are examples showing the shape of the light-shielding member 20 schematically. As shown in FIG. 3A, at least a part of the light-shielding member 20 may be formed in a bellows shape. As shown in FIG. 3B, the light-shielding member 20 may be formed in a flexible bag shape at least in part. As shown in FIG. 3C, at least a part of the light-shielding member 20 may be telescopically configured and may be stretchable in the axial direction.

The light-shielding member 20 is preferably configured so as to be stably held in a state of being connected to the main body case 30 and the expansion member 10. 4A to 4D are drawings that specifically show an example of this connection method. Although FIGS. 4A to 4D schematically show the connection state between the light-shielding member 20 and the main body case 30, the same applies to the connection state between the light-shielding member 20 and the expansion member 10. Method can be adopted.

As shown in FIG. 4A, a convex portion 25a is provided at the end of the light-shielding member 20, and a convex portion 35a is provided at the end of the main body case 30. Further, a concave portion corresponding to the shape of the convex portion 35a of the main body case 30 is provided at the end of the light-shielding member 20, and similarly, the shape of the convex portion 25a of the light-shielding member 20 is provided at the end of the main body case 30. A recess corresponding to the above is provided. Then, by fitting the convex portion 25a provided on the light-shielding member 20 and the concave portion provided on the main body case 30, and the concave portion provided on the light-shielding member 20 and the convex portion 35a provided on the main body case 30, respectively. , The light-shielding member 20 and the main body case 30 can be connected.

As shown in FIG. 4B, the tip 25b of the end of the light-shielding member 20 is brought into contact with the upper surface of the tip 35b of the end of the main body case 30, and the light-shielding member 20 and the main body case 30 are connected by the friction generated at the time of this contact. Can be. In this case, at least one of the tip 25b at the end of the light-shielding member 20 and the tip 35b at the end of the main body case 30 can have a fine uneven surface.

As shown in FIG. 4C, both the end portion 25c of the light-shielding member 20 and the end portion 35c of the main body case 30 are threaded, and the light-shielding member 20 and the main body case 30 are connected by screwing both of them. Can be.

As shown in FIG. 4D, a magnet 25d is provided at the end of the light-shielding member 20, a magnet 35d is provided at the end of the main body case 30, and both magnets (25d and 35d) are attracted by magnetic force to attract the light-shielding member 20 and the main body case. 30 can be connected.

[Another Embodiment]
Hereinafter, another embodiment will be described.

<1> At least a part of the housing of the main body case 30, the light-shielding member 20, and the expansion member 10 may be partly or wholly black for the purpose of preventing ambient light and extra reflection. For example, it may be composed of a black substance or may be colored black.

At least a part of the housing of the main body case 30, the light-shielding member 20, and the expansion member 10 is provided with fine unevenness on the surface on the side through which the excitation light 5 and the fluorescence 6 pass for the purpose of preventing diffused reflection. It doesn't matter.

<2> In the above embodiment, both the light source unit 32 and the light receiving unit 35 are housed in the main body case 30, but the light source unit 32 is housed in a housing separate from the light receiving unit 35. It doesn't matter if it is.

<3> In the above embodiment, the case where the fluorescence observation unit 1 includes the main body case 30 has been described, but it is also possible to adopt a configuration in which the main body case 30 is not provided. For example, the optical member provided in the light receiving portion 35 is connected to one end of the light shielding member 20, and the expansion member 10 is connected to the other end of the light receiving member 20, so that the light receiving portion 35 and the expansion member 10 are connected. A closed space may be formed between the two.

<4> In the above embodiment, the dichroic mirror 33 has been described as being configured to reflect the excitation light 5 and transmit the fluorescence 6, but the opposite may be true. That is, the dichroic mirror 33 may be configured to transmit the excitation light 5 and reflect the fluorescence 6.

Further, in the above embodiment, the configuration in which the fluorescence observation unit 1 separates the excitation light 5 and the fluorescence 6 by using the dichroic mirror 33 has been described, but only the fluorescence 6 can be separated and incident on the light receiving portion 35 side. If so, it is not necessary to use the dichroic mirror 33. For example, a configuration can be adopted in which the excitation light 5 is irradiated to the suspected positive affected area 42 through an optical fiber. Even in this case, since the fluorescence observation unit 1 includes the light-shielding member 20, the fluorescence 6 travels in the closed space, so that the fluorescence 6 is prevented from being mixed with ambient light.

<5> The wavelengths of the excitation light 5 and the fluorescence 6 described above are examples, and are appropriately selected according to the observation location and the disease to be specified.

1: Fluorescence observation unit 5: Excitation light 6: Fluorescence 10: Expansion member 11: Upper blade member 12: Lower blade member 13: Handle part 20: Light-shielding member 21 and 22: End of light-shielding member 30: Body case 31: Case Body 32: Light source 33: Dichroic mirror 34: Optical member 35: Light receiving 40: Hollow organ 41: Outer surface opening 42: Suspected positive affected area

Claims (7)

A light source unit that irradiates the suspected positive affected area in the inner observation site of the hollow organ whose outer surface opening is expanded by inserting the expansion member, and a light source unit.
A light receiving part that receives fluorescence emitted from the suspected positive affected part by irradiating the suspected positive affected part with the excitation light, and a light receiving part that receives the fluorescence emitted from the suspected positive affected part.
A tubular light-shielding member that shields an optical path from the surface of the expansion member on the light-receiving part side to the light-receiving part,
A main body case for accommodating the light receiving portion is provided.
The light-shielding member is connected to the surface of the main body case on the side where the fluorescence is incident.
The excitation light is guided to the suspected positive affected area through the inside of the light-shielding member and the inside of the expansion member.
A fluorescence observation unit characterized in that the fluorescence is guided to the light receiving portion through the inside of the expansion member and the inside of the light shielding member. The fluorescence observation unit according to claim 1, wherein the expansion member is a speculum. The fluorescence observation unit according to claim 1 or 2 , wherein the light-shielding member is physically deformable. The fluorescence observation unit according to claim 3 , wherein at least a part of the light-shielding member is formed in a bellows shape. The fluorescence observation unit according to claim 3 or 4 , wherein the light-shielding member is made of an elastic member. The fluorescence observation unit according to any one of claims 1 to 5 , wherein the light-shielding member is made of a low autofluorescent substance. The fluorescence observation unit according to any one of claims 1 to 6 , wherein the excitation light has a wavelength of 410 nm or less.

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